Faced with the barrage of whiplash-inducing headlines, I could only ask, “Haven’t we been here before?”

As a medical writer since the 1970s, I’ve seen the boom-and-bust-cycle play out for dozens of supposed miracle cures.

Take the endorphins – a family of natural chemicals made by the human body that work similarly to painkilling drugs like morphine. Endorphins were claimed to provide natural pain relief, while imbalances in endorphins were thought to underlie chronic pain, drug addiction (the “self-medicating” hypothesis), mental illness, and even the placebo effect. In the late 1970s, one drug in this class, FK 33-824, entered early clinical trials. Then it disappeared.

Years later I asked a scientist who had been heavily involved in endorphin research what had happened to this compound. “Have you seen anything more about it?” he asked me. “That’s your answer.” Severe safety problems sandbagged the drug. Nowadays endorphins only survive in popular references to the highly touted (but probably mythical) “runner’s high.”

Weight loss is the most notorious example of the boom-and-bust cycle. Starting with amphetamines in the 1950s, many compounds have been billed as safe, effective weight-loss drugs. None has survived the ultimate test: long-term daily use in humans. Drug after drug has been pulled from the market after causing serious side effects, from addiction (amphetamines) to fatal high blood pressure and heart defects (fen-phen in the 1990s) to sibutramine, which was just removed from major markets last year.

To quote the immortal words of Yogi Berra, “This is like deja vu all over again.”

Two things seem clear to me. First, people want to lose weight or enjoy a healthy old age the easy way. We don’t want to break a sweat or give up pleasures such as rich food and alcohol. Pleasure and comfort are powerful motivators; they seem to be hardwired into our brain’s reward system.

Second, pharmacological approaches to behavioral health don’t work and often have serious adverse effects. Our body knows what our brain denies; there are no shortcuts to health. Even that old conventional standby the multivitamin has come under fire as being useless, as LWON’s own Christie Aschwanden has reported.

I, too, hate all the peeling and chopping and disposing of rinds and seeds and skins necessitated by a fruit and vegetable-heavy diet. And don’t get me started on artichokes. However, it looks like there may not be a shortcut even to getting the benefits of fruits and vegetables. Maybe the Bible was on to something with that business about earning good things by the sweat of our brow.

As a June Science News article on sirtuins concluded: “So for now, people are left to protect their aging bodies the old-fashioned way, by exercising enough and not eating too much.” To which I would add, Don’t throw away your running shoes yet.

9 thoughts on “Guest Post: Why the Secret to Losing Weight and Staying Young Won’t be Found in a Pill”

Thanks for the great post, Bill. You highlight an interesting irony–the incredible amount of work, focus and energy that people have put into finding ways to not have to work so hard to stay healthy! And speaking of which, I think I’d rather peel apart artichokes all day long than run enough to find out whether there really is a runner’s high. And I guess that means I should go find some running shoes, huh?

I’m probably closer to your age, Bill, than the rest of these young sprats. And I thank you for reminding me what my grandmother always said: no easy way through this. Though like Tom, I’m not going to take the hard way so far as to start running.

It’s certainly true that many people have a great aversion to exercising. To undergo major surgery –sometimes more than once — rather than eating moderately and exercising moderately — that’s incomprehensible to me. You would think that eventually folks would realize that the seemingly easy ways don’t work. To paraphrase the inimitable Sherlock — “When you have eliminated the easy, whatever remains, however difficult, must be the way.”

What’s interesting about the reluctance to exercise is that we’re not born that way. As you know from firsthand experience, Tom, toddlers quickly graduate to juggers on their own initiative. As my wife once said while observing children, “Never walk when you can run.” So exercising is not something that we need to learn to do, it’s not-exercising that is the learned behavior. If we would simply not interfere with a child’s natural tendency, the obesity epidemic would disappear.

Ann —

Yes, I believe that we both go back a ways. Somewhere in the dim recesses of my brain I have a few flockering neurons that tell me that you too worked for Warren Kornberg way back when.

As for running, of course it’s not for everyone. Nor is it necessary for health. Go to Pubmed and put in “physical activity and health” along with “Manson JE” and you’ll see abundant proof of this. JoAnne Manson and her Harvard colleagues have accumulated much evidence that running is not necesary to get the benefits of exercise. Brisk walking is quite adequate. Even gardening has benefits. Here is a sentence from one review:

“In a sedentary society, public health initiatives that promote moderate increases in physical activity may represent the optimal balance between efficacy, feasibility, and safety to achieve the desired cardioprotective effect.”

So ignore those fanatic runners — just lace up your walking shoes or roll out your bike for a pleasant tour of the neighborhood.

Warren was the most challenging editor I have worked for. He had a clear idea of what constituted “a Mosaic story”. I was still working to get the hang of it when the NSF folded the magazine.

Phil —

Thanks very much for referring me to that slide lecture by Dr. Mike Evans. He seems like quite a knowledgeable educator. To me, Evans’ illustrated talk is a very nice response to the problem of getting laypeople to understand unpalatable scientific facts, as discussed recently by Christie in reference to climate change.

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Michelle and Ann are both in the 2017 edition of Best American Science and Nature Writing, Michelle for The Parks of Tomorrow in National Geographic, Ann for Inside the Breakthrough Starshot Mission to Alpha Centauri in Scientific American. Notable mentions in the same edition were Christie’s Failure is Moving Science Forward in FiveThirtyEight.com and Erik’s Why Great Sharks Are Still a Mystery to Us for National Geographic.

Christie won a 2016 AAAS-Kavli Science Journalism award (big deal) for a FiveThirtyEight.com series on p-hacking your way to scientific glory. One of that series, called Science Isn’t Broken also won a Kantor Information is Beautiful award. Classic Christie: “When the first analysis you try doesn’t spit out the result you want, you keep trying until you find one that does.”

Erik’s first book, called Suggestible You, just came out. Apparently when you’re raised Christian Scientist, you develop an abiding interest in what affects peoples’ beliefs. Classic Erik: “Your brain doesn’t want to be wrong — and in order for expectation to match reality, it’s willing to bend a few rules or even cheat outright.”

Emma won a 2016 Science-in-Society award given by the NASW for Handle with Care published in the May/June 2015 issue of Orion Magazine. Classic Emma: “Suddenly the vacant lot in Detroit is wilder than Yellowstone . . .”